【摘要】 目的调查分析既往及正在执行的结核病控制项目在改善中国流动人口结核病服务获得和利用方面所采取的相关政策文件和干预措施,并评价其效果和影响,为进一步开展结核病防治工作提供依据和建议。方法计算机检索MEDLINE、PubMed、CNKI、CBMdisc、万方学位论文全文数据库及VIP,纳入1988～2008年发表的关于流动人口结核防治工作的文献。同时采用非概率目的性抽样方法,在获得访谈对象知情同意后进行现场访谈。结果共检索到58篇文献,其中符合纳入标准的已发表文献8篇,未发表文献5篇,但其中仅有1篇为RCT,质量仅为B级。二次文献研究结果显示:我国目前对流动人口结核病防治采取的措施包括健康促进、提供激励机制、对病人实行督导管理等,且采取不同干预后病人知识知晓率、结核病治愈率均有所提高;但现场访谈结果显示,多数结核病人及疑似病例对于结核的防治知识及免费政策知晓不够,地区间结核病階治机构间没有有效的信息交流,致使流动人口追踪督导困难,结核病人的发现、治疗仍有待加强。结论现有针对流动人群的结核病防治研究中,缺乏高质量研究,因此难以对流动人口的结核病干预措施的效果做出客观、公正的评价;今后应开展专门针对流动人口结核病控制的大样本、多中心、高质量的RCT研究,为制定科学可行的干预设计方案提供依据。更多还原

【Abstract】 Objective We investigated and analyzed past and ongoing welfare programs related to health equity,and the relevant policies,documents,and interventions measures for improving China’s migrant worker population’ s accessibility and utilization of tuberculosis(TB) control services in TB control programs.Then we evaluated their impactin order to provide evidence and suggestions for the further TB prevention and treatment.Methods We retrieved published documents about TB prevention and treatment of the migrant worker population dating from 1998 to 2008 from MEDLINE,PubMed,CNKI,CBMdisc CDDB,and VIP electronically.Simultaneously,a series of interviews was conducted with patients who used the programs.Results Totally,58 documents were retrieved.Of these documents 13 passed eligibility criteria:eight have been published,fi ve have not been published,and only one of them is RCT with B degree for quality of evidence.Secondary document research has suggested that the intervention measures that have been adopted concerning TB in China,including health promotion,providing incentive,patient tracking and supervision management.Although tuberculosis cure rates have improved,the scene interviews show that the majority of TB and suspected cases of patients don’t have enough knowledge on TB prevention and free treatment policies.It is often diff icult to track the migrant population.TB detection and treatment still need to be enhanced.Conclusions There it is lack of high-quality documents about good intervention design,so it is diffi cult to make a objective and fair evaluation to the effects of intervention on the migrant population.In the future,we should carry out large-scale,multicenter,high-quality RCTs specifi cally for TB controlin the migrant population in order to provide evidencefor making a scientifi c and feasible intervention project.更多还原